Mr. Sheldrake, on Distortions of the Feet. . 457 and lay in a direct line with the front of the leg; the toes were turned inwards, fo far, that when (he attempted to ...
To the Editors
of the Medical and Phyfical Journal.
Gentlemen,
In
May, 1800, J. Haythorne, Efq. cf Briftol, confulted me about his daughter, of whom he gave the following account. She had been healthy from her birth till about the age of two years, when fhe had a fever, and at the fame time lolt the ufe of all her limbs by (as it was fuppofed) a paralytic ftroke. From this fhe recovered 3 but it was foon obferved that the right foot was weaker than the other. As fhe grew, this defeat continued to increafe ; the foot became weaker, and deformed to fuch a degree that at laft (he had no power to ufe it; at leaft, it had no capacity for voluntary motion : it became rigidly fixed in its deformed ftate, with much tendency to increafe in deformity, in conlequence of the very imperfect mariThe left leg and ner in which fhe was able to walk about. foot began to afTume the fame appearances, though in a lefs degree; ele&ricity, the Bath waters, See. and every means that could be devifed to obviate or diminifh this defeat, had been tried without efFecl, for it increafed fo much that at laft fhe could not walk acrofs the room without being led by an ailiftant and fupported by a flick ; fhe began to grow diftorted from the pelvis upwards j and as every circumftance of the difeafc was rapidly increafing, without any well-founded expe&ation qf reftoring the form and powers of the parts, application was made to me, to contrive l'ome means of preventing her from getting worfe, and, if poffible, of enabling her to move about in the^fituation fhe then was. At this time the right foot was, (as fuppofed) in confecootra&ion of the tendo achillis, fo drawn quence of permanent of the great toe, the heel, and the calf ball the that downwards of the leg were in a direft line with each other; the foot, by the apparent contraction of the plantar aponeurofis, was much fhortened, and rendered hollow on the bottom and the infide; the great toe was drawn up and permanently fhortened; the circular head of the aftragalus was out of its natural fituation, 1
Mr. Sheldrake,
on
Distortions
of the
Feet.
.
457
and lay in a direct line with the front of the leg; the toes were turned inwards, fo far, that when (he attempted to ftand or walk, flie refted upon the nails of the three middle toes, as the great toe did not touch the ground : In confequence of this ftate of the foot, every attempt fne made to walk or ftarid upon it tended to increafe the deformity; the leg was flaccid, much wafted, and fhe was not confcious of any degree of fenfibility At this time I had a caft in plafter either in that or the foot. of Paris made from the foot, in prefence of Mr. H. who obferved, that the workman placed the foot as near the natural pofition as it was pollible to be in when he made the mould ; from this caft I made four views, in different directions, which are in the annexed Plate 5, and will give a correct idea of the ftate of the foot at the time. The left foot had made fo much progrefs towards the fame ftate, that, in any other patient, it would have excited confiderable alarm; but in this was fcarcely confidered, or at moil: only as fecondary in point of confequence to the other. Both the knees bent inwards, and the diftortion that was beginning to take place above the pelvis, had as yet produced no permanent deformity; and as it was merely the eflre?t of peculiar portions occafioned by the deranged action of the legSj it was at this time not
an
objedt
1
of attention.
Mr. H. when he applied to me, had no expectations of obtaining more than palliative relief; but, in confequence of my opinion, was induced to place her under my care, to fee what could be effected towards obtaining a cure. Before the end of the firft week that file was under my care, fhe felt a warm fenfation pervade the whole of her right leg, which tili then had not evinced the leaft fenfibility; and this fenfation became fo permanent, that much attention was requifite, during the pro-? grefs of the cure, to prevent it from becoming exceffive; the form of the foot foori underwent a material change, and continued to do fo progreffively till laft December, when (he was able to ftand flat on the fole of her foot; and while {landing upon it, there was little in its appearance to diftinguifh it from the foot of any other perfon. At this time I had a fecond caft made from the foot^ and from this caft I have made the four views reprefented in the annexed Plate 6, viz. Fig. I, a profile view of the infide of the leg and foot j. Fig. 2, a front view of the fame ; Fig. 3' a profile view of the outfide of the leg and foot; and t ig. 4, a back view of the fame. In making the drawings reprefented in Plate 5, I;placed the leg in the fame fituations as the leg in Plate 6, confequently, by comparing the, feet in each platea with thofe marked with correfponding numbers in the other, corre?t opinion may be formed of the alteration produced in the *umb. xxvji. N ii 11 -form *
Afr.
458
Sheldrakej
on
Distortions
of
the Feet.
form and appearance of the foot at the different periods when the cafts were taken. A -circumftance at leaft as remarkable as the alteration in point of form, is the increafe of fize in the whole limb that has taken place during the time that has been employed in the cure; partly by the alteration in point of form,, which is the conference bf reducing the foot to its natural ftate,. but more by the abfolute increafe of fize in the whole limb during the progrefs of the cure. To fliow what this has been, I fubjoin an accurate meafurement of the two cafts, and have marked with a dotted line on fKg. i, plate 6, the dire?lion in which thefe Oieafures were taken, viz. 1Diseased Foot.
Length of the foot, Breadth of the foot at the toes, Circumference at the toes, Over the inftep and round the heel,, Smalleft part of the leg, Largeft part of the leg,
6 | inches, 3 inches, 7 \ inches, g inches, 5 \ inches, 3
\ inches,
Restored root*
7 | inches 3 { inches 8 r inches. 10 5 inches 6i inches 9 \ inches
thefe circumflances may feem, as the moprefence of Mr. H. and other perfons equally refpedtable, and as they are ftill in my pofl'effion, it will always be eafy to prove that thefe circumftances are. incontrovertible facts. As the reduction of the foot to this ftate is the moft ftriking part of this cafe, it was my intention to fend the hiffory of it at this period j but as other avocations have prevented me from doing fo, I have an opportunity now to add, that though fo much alteration in point of form cannot take place fince the period when the laft model was taken as did before that time, yet minuter alterations have taken place fo faft, that I am now warranted in faying, this foot will be perfectly reftored to its natural form, and that no one circumftance will remain to fhow that it has been diftorted. I might perhaps be juftified in faying as much of the reftoration of its natural powers; but as I would avoid the imputation of rafhly advancing too much, I fhall content my felt with ftating the fa?t, that fhe has lately been able to walk three miles without inconvenience ; and when it is remembered, that ten months ago fhe could not g,o fo many'yards without afliliance, and as fhe is mending rapidly to form his own conclusions every day, I (hall leave every one on the fubje?L I have laid nothing of the left foot; for, although, if it had been the only one difealed, it would have been an object of imthe portance, it was but very little diftorted in companion with recoverit obfervc is to and it fufficient is now other, equally ed ; the tendency to a diftorted fpine too, in confequence ot the. alwrauojk
Extraordinary
dels
were taken
as
in the
I
Mr. Sheldrake,
on
Distortions
if the
Feet.
459
alteration in the legs, has difappearpd without requiring any affi fiance, though if the diflortion of the legs and feet had con-
it is certain that very ferious incurvation of the fpine Would have taken place. As I wifh to avoid every imputation of exaggerating any circumftance of this cafe, it is neceffary to add, that I tranfmitted the above Narrative to Briftol, and have received the following letter from Mr. H. in reply.
tinued,
"To Mr.
Sheldrake,
No. 50, Strand.
"
Dear Sir, I have forwarded by the mail coach of this day, your Narrative of my daughter's cafe, which I have perufed with the moll affectionate intereflr, and confirm in its fulleft extent, heartily wifhing its publication may excite general attention to I congratulate you your important and invaluable difcovery. and myfelf that this cafe, fo happily treated hitherto, and proclaim mifing complete fuccefs in the event, will efta^lifh your I am extremeto the approbation and applaufe qf all mankind. ly concerned that this wonderful cafe cannot be farther confirmed by the teflimony of that worthy gentleman* who was the caufe of my placing the child under your care ; his profeffional chara&er, no doubt, would have had great weight; he had fcen the firfl: and fecond models, and, on that proof of advanme to hope the cure would be comtage gained, encouraged feen the laft, I am convinced he have lived he to had plete *, would have been happy to have had this opportunity of offering this public "acknowledgment of your merit, in conjunction Dear Sir, with, " Your obedient friend and fervant, " i8qi. John Haythorn'e. Bristol, 14 April) "
" P. S. I beg you will refe? any perfon defirous of feeing' the models in this part of the kingdom to me; and, in cafe another is taken for yourfelf, that I may have one alfo."
anomalous one, in which the effe& had proved beneficial to the patient, I might now take leave of it with thole fenfations that naturalferviceable ly will arife from the confcioufnefs of having been ?to others; for as no fituation can be more powerfully contraffced than that of this patient, ten months ago, when fhe was jjlmoft helplefs, and had no other profpedt than that of increasIf the above cafe
of fome
*
was an
lucky experiment
,
The late Mr. TownfenJ, furgeon, of Briftol, who is recently deceafed.
460
(
Mr.
Sheldrake,
on
Distortions
of
the Feet.
ing debility and its confequences, with that in which fhe is at prefent, almoft reftored to the full ufe of her powers, with life and all its profpe&s opening before her; fo the refle&ion of having produced the alteration would be fufficiently gratifying : But as this is one very ftrong example of a very numerous clafs of difeafes, few cafes of which have been radically or even palliatively cured, and as the fuccefs in this cafe was the conference of an accurate inveftigation of the alteration produced in the parts by whatever caufed the difeafe, and a minute and laborious application of the means reqiiifite to reftore thofe parts to their natural ftate, and as the fame principles, if Ikilfully adapted and feduloufly applied to the /nany varieties of the fame difeafe, will, in all probability, prove equally fuccefsful as it has done in this, I truft I fhall be excufed for adding a few
pbfervations on the fubjeft. We continually hear of what are called contra&ions of the limbs, arifing, in all probability, from many different caufes ; connected, it is equally probable, with very different flates of the parts : yet the opinions of profeflional men are not fo far fettled as to point out any general fyftem upon which they may be treated with a probability of fuccefs; while the empiric, who perhaps has known fome benefit produced by fome remedy in one cafe, boldly applies the fame remedy in all cafes that he he is pleafed to call by the fame name, and thus goes on, promifing much good, and doing no little mifchief, till he is at laft funk in oblivion. It is in order to refcue the fubjeft from this ftate of confufion that thefe obfervations are written ; and I therefore hope, if they fhould not be fuccefsful, the attempt will be exciifed, and fome more fortunate and more able hand be prompted to do juftice to the fubjeft. What is a contradled limb? To fome this queftion may feem unneceffary ; but as I wifh to define, accurately, the data upon which I mean to argue, I (hall be excufcd for'obferving, that by the term contracted limb I underftand only that which, by the fpafmodic action of one or more mufcles, or by the loi's of fubftance or alteration in the natural texture of fome mufcles pr tendons, is drawn into and firmly fixed in an unnatural pofition. Of this clafs of difeafes, the cramp and its confequenas caufes much in ces point. may be mentioned of exercife unufually violent, and in confequence When, continued for an uncommon length of time, the legs become fatigued, and the patient lies down to reft without properly guarding himfelf from the effedfs of cold, the gaflrocnemii mufcles fuddenly and violently contra# theinfelves, and forcibly draw the feet into a peculiar pofition, in which they become fixed, and this is attended with excruciating pain to the fufferer, which is much increafed by any forcible attempts to reftore
Mr. Sheldrake, them
on
Distortions
of
the Feet.
4^r
It is eafy to fee, that if this efto their natural pofition. fect was permitted to continue for a long time, the motion of the feet muft ceafe; the pain in the contracted parts would diminifh as thev become accuftomed to their fituation, and, at laft, would totally ceafe, except when any attempts were made It is likewife eafy to fee, that if to force them into a?tion. this effect was continued for a longer time, fuch an alteration might take place in the organization of the contra&ed mufclcs The or tendons, as would conftitute an irremediable difeafe. rational mode of curing this clafs of difeafes in their early ftages, and attempting to cure them in their more advanced ones, would be the ufe of the warm bath and fuch applications as can relax the parts, and mechanical applications or eftorts to bring thofe parts into action in proportion as they become relaxed; but it is extremely probable, that if a pofitive alteration had taken place in the ftru?ture of the contradted parts, that this fyfrem of treatment would produce no benefit whatever ; that if incautioufly practifed it would produce much pain; and if by misfounded fortitude in the patient, or imprudent perfeverance in the operator, it was-continued to excefs, great inflammation in the parts might take place, and very ferious confequences might enfue, without the poflibility of obtaining any advantage to compenfate the rifk. Of the fuccefs of this mode of treatment, when it is fuccefsful, it cannot be fuppofed that I fhould know much, for it is not connected with my pra?tice, and patients who have been relieved by it, need to feek no farther afliftance; of its failure in thofe cafes in which 1 have faid it is very unlikely, if not abfolutely impoffible, that fuch treatment fhould fucceed, I have much information; and I muft add to this, that I have no knowledge of any means by which fuch contractions as are occaiioned by alteration in the ftru?ture of contracted parts can be cured. Of this clafs I fhall briefly mention two cafes out of the many that have fallen under my obfervation. A gentleman in India went to fleep very imprudently in an expofed lituation ; he waked in excruciating pain from the cramp; the flexor mufcles of the thigh and leg were fy contracted, as ro bend the leg into the pofition it ufually is when we fit down, and in this pofition it was permanently fixed. ,A11 attempts to remove the contraction were ineffectual; he returned to England, and fought for affiftance here without fuccefs, and at laft applied to me. As every thing that could be done under the idea of relaxing, See. had been tried, and as it appeared to me to be a cafe of permanent incurable contraction, I was not willing to make any attempt, but advifed that he fhould try, by means of an affiftant, whether the parts could be brought to ad in any manner; thefe attempts, however, were attended
46-2
,
'Mr.
Sheldrake,
attended with fuch
0/z
Distortions
excruciating pain,
of the
that
Feel.
they
were
foon dif-
continued, and the patient remains in the fame ftate as when I faw^him firft. In the year 1795, I was called to the fon of a gentleman in
Ireland ; there was a general tendency to contra&ion in all the flexor mufcles of the thighs, legs, and feet; when he lay down, his knees were drawn upwards, and his toes pointed ftrait forwards ; when he attempted to walk, it was only by holding a table or the chairs, and upon his toes, with his knees bent. The warm and vapour baths, ele&ricity, fomentations, and relaxing applications had long been tried, it was faid, with good effect, and I was afked to contrive fuch inftruments as would extend and keep the limbs extended in proportion as the applications that werje ufed would enable the parts to bear exlenfion. I did lb, and the plan was followed with much perfeverance, and for a great length of time; but at laft all the remedies were thrown afide, as no benefit was derived from them; and ifj^-the patient be ftill living, I conclude he is in the fame condition as when I f^rft faw him. By thefe and many other cafes that have fallen under my obfervation, I am autborifed to. fay, that although the ufe of relaxing applications may cure fome cafes of contraction (adhering to the definition I have given of the term) yet, in general, they are ineffe&ual, and a fuccefsful method of curing thofe difeafes is ftill a defideraturn in furgery. To thofe limbs which, like that of Mifs H. are fixed in one pofition, and which arc not diftorted by contraction, in the fenfe I have ufed that word, I would apply the term rigid, as indicating their condition, without fpecifying the caufe of it j diftorted limbs of this kind may be occafioned by many differ-. ?nt caufes, among the moft frequent of which are the follow*. ing, viz. Luxation of joints, &e. which by weakening the connecting ligaments and particular mufcles, alter the polition, and derange the natural a&ion of the limb, and thus throw it into an improper fituation, in which, at laft, for want of profixed. In confequence of per action, it becomes permanently removal of that the difeafe, due care is not palfy, when, upon taken to place the limb in that fituation which is moft favourable to enable it to regain its natural powers; and many others, which as their effects are exa&ly the fame, it is needlefs to particulate here. The capacity for mufcular motion in any limb depends upon the exa?t proportion of the power of the flexor and extenfor mufcles to each other, by which means it is enabled to perform its fun&ions with propriety; of courfe, by whatever means the powers of thofe two fets of mufcles are rendered of its adion, and deformity in its fhape,
unequal, derangement
Mr. Sheldrake,
on
Distortions
of the
4^3
Feet.
maft be the confequence ; that inequality, once eftablifhed, will continue to increafe till the adtion of one fet is deftroyed, and that of the other will ceafe of courfe; the limb will be motionlefs, lofe its flexibility, and diminifh in fize, its fenfibility will become latent, and, at length, the whole limb be reduced as near to a lifelefs ftate as a part of the living Animal can be. Such was the condition of Mifs H's foot; fuch is the condi-t tion of many limbs called contracted, which are improperly treated, and finally abandoned in defpair; when, by a different mode of treatment, be reftored to their priftins
they might
vigour.
As this is a point of much importance, I fhall perhaps be excufed for proceeding a little farther upon it. If this difeafe is called contraction, and it is treated with what are callea emollient or relaxing applications, what will be the conlequence. The original caufe of the difeafe is debility in particular mufclesj and it certainly is not eafy to conceive how the. application of relaxing remedies to parts which have loft their power of adding from mere debility, can reftore thofe parts to their natural ftate; it is eafy to underftand that the application of thefe remedies muft be, at beft, ufelefs, when adminiftered in every poffible form, if they did not accelerate the progrefs of the difeafe; thus, by calling that difeafe contraction which in fa?t was debility, a method of treatment was adopted which was
not
adapted
to the nature
o?
the
difeafe;
and
when it
is confidered how many fimilar cafes there are which are treated upon the fame principles, and with precifely the fame refult, this attempt to place the fubje?t in its proper point of view may not be found unnecefiary to future fuccefs.^ The leading principle upon which I acted in this cafe, and which, I believe, will prove fuccefsful, if fkilfully applied, in every other that is not in its nature incurable, was to reftore the powers of thofe parts which had loft them as the diftortion came on, from a perfuafion that, if this could be done, the form and adtion of the whole limb would be reftored of courie. ot er am aware that this has been attempted by electricity and mention not I therefore merely with means, though fuccefs, the circumftance, as it might feem invidious to enquire mieen e nutely into the caufes of failure when thofe means ha\
employed. r "i t at mu cu ar I had learned, in the fchool of Mr. Hunter, re or motion, artificially excited, would in time pio uce 1 on w
\
,
?
mufcular power; to the difcovery of the principe thefe difeafes fhould be treated, then, I hav^. no c aim ; a merit I am entitled to, if it deferves the name, B that of hgtv- I ing contrived the means oi reducing thib princip> to prac ice.
jc
s
Mr.
464.
Sheldrake,
on
Distortions
of the
Feet.
of a very numerous clafs of difeafes, and to any that may be required. This cafe of Mifs H. has been called paralytic; if it was fo, then is this method to be called a cure for palfy; but there is abundant reafon to believe that if palfy was the primary caufe of this debility, and its conlequent diftortion, that palfy had been and all the effe&s I faw were merely the long removed, eftedis of debility; it is not a little Angular that the fenfibility ot which this leg had been lo long and fo compleatly deprived, as to give rife to a notion that it laboured under the influence of palfy, fhould be fo compleatly reftored in a few days, that ?much attention was requiiite during the progrefs of the cure to prevent its becoming exceffive; the increafe of fize too, notwithftanding the conftant application of the bandages, he. neceflary to effedt the cure is fo very remarkable, that it requires every voucher of its authenticity to be carefully examined before implicit credit will be given to the account of it. If any {hould object that I go too far in arguing, from the cure of this cafe, that every other cafe of the fame defcription may as certainly be cured, I fhall beg leave to obferve that the greateft certainly includes all the lefs, and many cafes of the fame kind, but lefs in degree, I have had under my care, fucceeding equally with them all; I believe too it is fair induction to fay, that if there are wOrfe cafes of the fame kind, it is very probable, nay almoft certain, that the fame means, if duly proportioned, and feduloufiy applied, will certainly cure every cafe, however bad it may be, till it arrives at that point which oppofes fome phyfical impoflibility to prevent our fuccefs. At what period that impoffibility may take place it is not eafy to fay, though it certainly does not fo early as it has been fuppofed ; and it is extremely probable it will be much later in life, and much lefs frequently, than many will imagine. As it is of confequence that this doctrine fhould be firmly eftablifhed, I fhall perhaps be excufed for fupporting it by referring to a quarter from whence information on this fubject might not be expected. A late author,* in defcribing the extraordinary mortification of a devotee, fays, "The compleat term of his firft penance being expired, the next he undertook was to hold his hands, locked in each other, over his head, the fingers of one hand dividing thofe of the other, for the fame fpace of twelve years, ?-When I firft faw him at this place, in the year J 783, he rode on a piebald Tangun horfe from Bootan, and wore a fatin in the
cure
degree
embroidered
*
Turner's
Embafly
to
the court of the Teflioo Lama,
Mr, Sheldrake,
on
Distortions of the Feet.
4^5
to him by Tefhoo Lama, of which he little vain. He was robuft and hale, and his complexion, contrafted with a long bufhy black beard, appeared really florid. I do not fuppofe that he was then forty years of age. Two Gofeins attended him, and affifted him in mounting and alighting from his horfe j indeed, he was indebted to them for the affiftance of their hands on every occafion; his own being fixed and immovable, in the pofition in which he had fixed them, were of courfe perfectly ufelefs. " The circulation of the blood feemed to have forfaken his arms, they were withered, void of Jenfation, and inflexible ; yet he fpoke to me with confidence of recovering the ufe of them, and mentioned his intention to take them down the following year, when the term of his penance would expire. " Other Gofeins allured me, though I could not help doubting the faft) that it is pra&icable to reftore withered limbs, thus circumftanced, to perfect ufe. This is effected, they fay, though not without great labour and fome pain, by means of long continued friction, before a.large fire, with a certain ointment which they compound." The authority of thefe Gofeins is not to be very highly eftimated as to the furgical treatment of the difeafe, though they may fafely be admitted as evidences to the fa?fc mentioned bj Capt,, Turner. The appearance of the man fo crippled is not mentioned as unique, it is ftated, and indeed known, to be the regular practice of a certain defcription of perforis who profefs the fame religion; and though it is a fpecies of fuperilition, it is not of that gloomy kind which has led many to deftru?tion, but, with the calmnefs of miftaken philofophv, that man willingly rendered his arms ufelefs for twelve years, from a belief that the facrifice will be grateful to his Deity, and a conviction that at the expiration of the time mentioned in his Vow, he can take them down again, and recover the perfect ufe of them. His countrymen likewife believe this, and ftate the means by which it may be done, not as a matter of doubt, but as of the moft abfolute certainty, and, undoubtedly, not without fufficient reafon. There are no practices more antient than the fuperftitions of India; they have been invariably followed, without the leaft deviation, for a feries of ages, of which perhaps we have no adequate idea; and it refults from our knowledge of the facts mentioned by Capt. Turner, that perfons at the prefent time do what has been regularly done by their countrymen for time immemorial, render their arms ufelefs for the term of twelve years, and at the end of that term reftore them to their oriT. doubted the fa&, becaufe he bad ginal perfect ftate.
embroidered drefs given was not a
\
NUMB. XXVII.
Capt.
no
Ooo
\
466
-Mr:
Shtfdrah,
on
Distortions
of the
Feet-.
knowledge of any thing fimilar, yet the terms in which fte defcribes the-' man's arms, if the word leg was fubftituted For it, .would be very defcri'ptive of Mifs'H's leg; the cure of this is "Within.our and juftifics'us in believing- what is reflated 'pf this man by GaptvT*. which again will juftify us iix concluding that many perforis with the fame kind of defects^ and mtitfr' farther 'advanced, 'than that of Mifs H. is, may be that were employed in cuperfeftly cured by! the'fdme means fchuc'o to her. v/*~^v;oq ring Mr.,H; in;his'letter calls.this-a wonderful cafe"', others, who .are not equally affected. by it, may call .it an extraordinary one. As I do'Viot. wifri; for the reputation of v/orking miracles, and 'ain defirous to fubject what feems to be extraordinary to the judgement of thofe who are1 competent to decide upon it, I fliall ftate .What appears 'to me to be the progrefs of a limb in the condition this lady's was, from the healthy to the difeafed .-.ftate, and on'its return -to the Healthy ftate again'. In confluence of v/eaknefs, from; whatever Caufe, the extenfor mufdles of-'the foot we're incapable of performing their functions properly; the contra?tile a&ion of the flexorswas of tourfe increased, and the foot thus drawn into an unnatural pofition; 'this derangement,-deforifiity, and rigidity- increafed till file had:;no'pov/er to ufe the leg-; in this ftate it diminilhed in fize for want of-adtion, arid loft its fenfibility from the fame caufe. In this'ftate it was called a contracted leg and foot, and, increaied every application riiade to it,>-inftekl of curing, only its debility, and* at 'length it became lufeiefs. all the Having formed1 a different opinion of it, I avoided &c. as Il,wou!d have done the-ointment of Emollients, farrago of the :Gofeihs, .and confined my treatment to'the application of bandages-, rc6nfifting o'f fprings fo adapted as to imitate -the aflion of every mufcle whole: power was delkient, and bv altering adapting, and modifying thefe applications, lo as to of every mufcle in its turn, I proceeded by produce the acliori was> reduced to its natural form, and fo the'.foot till decrees well-founded inuch of its natural powers reitored, as leaves a be exterleaft difeafe of will the appearancehope that, every no
knowledge,
.
minated.
The phyfical alteration in the ftate of the parts feems to the following manner: By applying a have taken place in the fame pofition in which it to draw the foot' towards fpring of adion the any particular mufcle, that b'e woula placed-by mufcle is brought' to act though it had not before the power to do fo; and, in confequence of this action, the general circulaof tion is increafed through the whole limb; the confequence of veffels the is through enlargement this increafed circulation which
A:'
V
